HYDROCORTISONE

hydrocortisone 20 mg tablet, 60

HYDROCORTISONE (14476X)

hydrocortisone 20 mg tablet, 60
14476X
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 120 # of repeats: 4 DPMQ: $55.08 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Hydrocortisone Viatris 20
Hysone 20
*Additional charge for this brand is $6.00
 DPMQ: $61.08 Max safety net: $25.00 General Patient Charge: $31.00